1. Ethical Dilemma Emily Greenwell, OTS

2. Dilemma #20  Like many other facilities, your hospital has decided to reorganize. You have been appointed to head up the head injury team. This means you now supervise health and rehab professionals in the several disciplines working with patients recovering from traumatic brain injuries. Among other things, you will be responsible for conducting performance appraisals. You are not really sure you understand the role of two of the disciplines under your supervision.

3. What is the problem?  I am now responsible for performing performance appraisals on each of the professionals under my supervision yet I do not fully understand the job description of two disciplines under my supervision.  I cannot provide fair and honest feedback on a performance appraisal if I do not fully comprehend what the job requires.

4. What are the facts of the situation?  The hospital has reorganized.  I now have a new position with new responsibilities.  I oversee the team working with traumatic brain injury.  I do not fully understand each of the disciplines under my supervision.

5. Who are the interested parties & what is the nature of their interest?  Myself  Professional: I need to what is required of my job, but want to remain ethical.  Personal: want to maintain a good personal reputation among colleagues.  Employer  Business: They need all employees (including myself) to do their job.  Economic: For the hospital to make money they need therapist working effectively.  The members of the team I lead  Professional: Need honest and fair feedback on performance review to maintain employment.  Economic: Need to keep job  Personal: do not want the embarrassment of a bad review.

6. Is there an ethical issues?  Nonmaleficence  (A) Avoid inflicting harm or injury to recipients of occupational therapy services, students, research participants, or employees.  Justice  (K) Report to appropriate authorities any acts in practice, education, and research that are unethical or illegal.  Veracity  (G) Be honest, fair, accurate, respectful, and timely in gathering and reporting fact-based information regarding employee job performance and student performance.  Fidelity  (H) Promote collaborative actions and communication as a member of interprofessional teams to facilitate quality care and safety for clients.

7. Is there a legal issue?  201 KAR 28:140. Code of ethics and unprofessional conduct.  Section 1:  (4) An OT/L or an OTA/L shall not use or participate in the use of any form of communication that contains a false, fraudulent, deceptive, or unfair statement or claim.

8. Do I need more information?  What are demands/ requirements of the two disciplines I do not understand?  Can I obtain a copy of the job descriptions?  Does my employer know I do not fully understand the role of two of the disciplines?  When am I required to complete the performance appraisals?

9. Next Step?  Contact my supervisor to inform him/her of the issue.  Obtain a copy of the job description for any discipline I do not fully understand so that I can educate myself and provide fair and honest feedback.